CMS Price Transparency Data

Hepatitis C antibody test

Facility: Saint Alphonsus Regional Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $87
  • Cash Discount Price: $81
  • vs. Medicare Baseline: 6.10x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Saint Alphonsus Regional Medical Center is $87. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $81. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 6.10x the Medicare baseline. Located in 1055 North Curtis Road, Boise, ID.
Cash / Self-Pay
$81

Average discount available for prompt cash payment at this facility.

Insurance Median
$87

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$14.27

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $14.27 (100%)
Cash / Self-Pay: $81 (568%)
Insurance Median: $87 (610%)
Cash: $81 (568% of Medicare)
Ins. Median: $87 (610% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $14.27 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 610% of the Medicare baseline (a markup of 510%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Ada County Jail Inmate Ins $12 - $41 84%
Centurion Of Idaho $12 - $41 84%
Id County Ada $12 - $41 84%
Id County Canyon $12 - $41 84%
Id County Cat Fund $12 - $41 84%
Id County Payette $12 - $41 84%
Idaho Dept Health And Wellfare $12 - $146 84%
Medicaid / KanCare $12 - $82 84%
Aetna $14 - $145 98%
Blue Cross Blue Shield $14 - $182 98%
Medicare (plans) $14 - $148 98%
Moda Health $14 - $279 98%
UnitedHealthcare $14 - $141 98%
American Health Advantage Of Idaho $15 - $147 105%
Blue Shield - Id (Regence) $16 - $71 112%
Asuris Northwest Health $21 - $71 147%
Blue Shield - Wa (Regence) $21 - $182 147%
Healthcare Management Admin $21 - $71 147%
Molina Marketplace $34 - $339 238%
Trillium Community Ohp $36 - $58 252%
Webtpa $38 - $379 266%
Mountain Health Co-Op $50 - $82 350%
Pacificsource Health Plans $50 - $99 350%
Selecthealth $54 - $241 378%
Cigna $56 - $186 392%
Priority Health $56 - $186 392%
Providence $56 - $186 392%
Allegiance $61 - $101 427%
Columbia Health Network $61 - $99 427%
Employee Benefit Management $71 - $116 498%
First Choice Health $71 - $116 498%
Humana $73 - $136 512%
Allied National Global Care $75 - $122 526%
Asrm - Reliance Standard Life Insurance $75 - $122 526%
Christian Care Ministry $75 - $122 526%
Dean Health $75 - $122 526%
Fallon Health $75 - $122 526%
Family Life Insurance Company $75 - $122 526%
First Health $75 - $122 526%
Geha $75 - $125 526%
Ghc Scw $75 - $122 526%
Healthnet $75 - $122 526%
International Benefit Administrators $75 - $122 526%
Lifetime Benefit Solutions $75 - $122 526%
Manhattan Life $75 - $122 526%
Medi Share $75 - $122 526%
Pai $75 - $122 526%
Pan-American Life $75 - $122 526%
Paramount Hmo $75 - $122 526%
Phcs $75 - $122 526%
Trinity Health Share $75 - $122 526%
Allied Benefit Systems $76 - $125 533%
Ameriben $76 - $125 533%
Asr Health Benefits $76 - $125 533%
Bcn Domestic $76 - $182 533%
Blue Benefit Administrators Of Massachusetts $76 - $182 533%
Blue Care Network $76 - $182 533%
Blue Distinction Transplant $76 - $182 533%
Blue Shield - Ca $76 - $182 533%
Blue Shield - Ny Highmark Northeastern $76 - $182 533%
Blue Shield - Ny Highmark Western $76 - $182 533%
Blue Shield - Pa (Highmark) $76 - $182 533%
Boon Chapman $76 - $125 533%
Christian Brother Services $76 - $125 533%
Health Choices $76 - $182 533%
Healthez $76 - $125 533%
Kaiser Domestic $76 - $182 533%
Luminare Health (Detroit) $76 - $125 533%
Meritain $76 - $125 533%
Pre-Employment $76 - $182 533%
Rural Carrier Health Benefit Plan $76 - $125 533%
Wc Domestic $76 - $182 533%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1055 North Curtis Road, Boise, ID 83706
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals